Assessment and accountability has been described as the "third revolution in medical care." Due to the high costs incurred for inpatient care, hospitals are often the primary target of this revolution. Many strategies have been implemented to achieve greater accountability of hospital care in order to improve quality and to manage costs. In this project, we will convene an invitational workshop comprised of leading business executives, hospital administrators, clinicians and health services researchers in order to critically examine current approaches to public accountability of hospitals and to discuss strategic directions that are needed to improve both the research and implementation of current hospital accountability systems. The specific aims of this workshop are: 1) To provide a politically neutral forum for business leaders, hospital executives, clinicians and health services researchers to examine critically current approaches to hospital accountability. 2) To assess opinions of these leaders through a questionnaire of quality of care issues, and to use the results to generate discussion among the participants. 3) Based on the workshop discussions, to identify research strategies and policy recommendations on future directions for hospital accountability. 4) To disseminate workshop proceedings through a series of articles in the Quality Review Bulletin, the media, and presentations at other national meetings. The workshop will be highly interactive. Two panels of speakers will be recruited. Panel 1 will feature current approaches to hospital accountability. Included will be speakers representing government initiatives, voluntary approaches and other programs. Panel 2 will discuss future directions for making information on hospital quality publicly available. Panel 2 will include health services researchers, business leaders, and individuals within hospitals who have operational responsibilities for quality of care programs. An invited audience will also participate in the group discussions.